TOTAL CLAIMS
1o
FOR
NUMBER FILED
NUMBER EXTRA
TOTAL CHARGEABLE CLAIMS
0 minus 20=
* ro
INDEPENDENT CLAIMS
^ minus 3 =
MULTIPLE DEPENDENT CLAIM PRESENT
□
BEST AVAILABL E COPY
PATENT APPLICATION FEE DETERMINATION RECORD
Effective October 1 , 2001
Application or Docket Number
CLAIMS AS FILED - PART I
[Column 2)
* If the difference in column 1 is less than zero, enter '0* in column 2
CLAIMS AS AMENDED • PART II
(Column W
(Column 2)
(Column 3)
ENTA |
"cOT5 1 I
REMAUNBNG
AFTER
AMENDMENT |
NUMBER
PREVIOUSLY
PAID FOR
PRESENT
EXTRA
S
o
z
Total
• 43
Minus
tu
I
Independent
• 3~
Minus
RRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM
U-J
(Column 1)
(Column 2)
|
l
i
REMAINING
AFTER
AMENDMENT
NUMBER
PREVIOUSLY
RAID FOR
PRESENT
EXTRA
Total
*
Minus
**
Independent
*
Minus
***
S
| FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM
_Q_
(Column 1)
(Column 2)
(Column 3)
EMTC |
I * cuuiiS 1 '
1 REMAINING
AFTER
AMENDMENT
HIGHEST
fsflJMBER
PREVIOUSLY
PAID FOR
PRESENT
EXTRA
2
Q
Z
Total
*
Minus
**
UJ
\
Independent
*
Minus
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM
□
* If the entry in column 1 Is less than the entry in column 2, write "0" in column 3.
SMALL ENTITY
TYPE
OTHER THAN
OR SMALL ENTITY
RATE
FEE
RATE
FEE
BASIC FEE
370.00
OR
BASIC FEE
740.00
XS 9=
OR
X$18=
is *
~X42=
OR
X84=
♦140=
OR
+280=
TOTAL
OR
TOTAL
OTHER THAN
SMALL ENTITY
OR
SMALL ENTITY
ADDI-
ADDI-
RATE
TIONAL
FEE
RATE
TIONAL
FEE
X$ 9=
OR
X$T8=
X42=
OR
X84=
♦140=.
OR
♦280=
TOTAL
ADOIT. FEE
OR T0TAL
U " AOEHT FEE
ADDI-
ADDI-
RATE
TIONAL
FEE
RATE
TIONAL
FEE
X$ 9=
OR
X$18=
X42=
OR
X84=
+140=
OR
+280=
TOTAL
ADOIT. FEE
OR.
TOTAL
aODIT. FEE
ADDI-
ADDI-
RATE
TIONAL
FEE
RATE
TIONAL
FEE
XS9=
OR
X$18=
X42=
OR
X84=
♦140=
OR
+280=
TOTAL
OR
TOTAL
ADOIT. FEE
*"tf the "Highest Number Previously Paid For" IN THIS SPACE is less than 3. enter *3.*
The 'Highest Number Previously Paid For* (Total or frwtependert) is the highest number found in the appropriate box in column 1.
FORMPTCW3 (Rev. B/Dl)
Patent and TrademwH Office. VS. DEPARTMENT OF COMMERCE